Premium
Mustard allergy confirmed by double‐blind placebo‐controlled food challenges: clinical features and cross‐reactivity with mugwort pollen and plant‐derived foods
Author(s) -
Figueroa J.,
Blanco C.,
Dumpiérrez A. G.,
Almeida L.,
Ortega N.,
Castillo R.,
Navarro L.,
Pérez E.,
Gallego M. D.,
Carrillo T.
Publication year - 2005
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2005.00644.x
Subject(s) - mugwort , allergy , food allergy , placebo , medicine , pollen , cross reactivity , dermatology , reactivity (psychology) , immunology , cross reactions , botany , biology , pathology , alternative medicine , antibody
Background: Mustard IgE‐mediated allergy is supposed to be a rare cause of food allergy, and its clinical features and cross‐reactivities have not been fully elucidated. Methods: A prospective study was carried out, recruiting mustard allergic patients, and paired control subjects. A clinical questionnaire was administered, and skin‐prick tests (SPT) with panels of aeroallergens and foods, serum extraction for in vitro tests and double‐blind placebo‐controlled food challenges (DBPCFC) were performed. Results: Thirty‐eight mainly adult patients, with 10.5% reporting systemic anaphylaxis, were included in the study [age (mean ± SD): 21.9 ± 8.6 years]. DBPCFC were performed in 24 patients, being positive in 14 cases (58.3%). Patients with positive outcome showed significantly greater mustard SPT than those with negative outcome (8.2 ± 3.7 vs 5.3 ± 2.4 mm, P < 0.05), and the receiver‐operating characteristic (ROC) curve analysis yielded a cut‐off value for mustard commercial SPT of 8 mm, with a specificity of 90% (95% CI, 55.5–98.3), and a sensitivity of 50% (95% CI, 23.1–76.9). A significant association between mustard hypersensitivity and mugwort pollen sensitization was found (97.4% of patients), with partial cross‐reactivity demonstrated by UniCAP System inhibition assays. All patients showed sensitization to other members of Brassicaceae family, and cross‐reactivity among them was also confirmed. Moreover, significant associations with nut (97.4%), leguminous (94.7%), corn (78.9%), and Rosaceae fruit (89.5%) sensitizations were also shown. Around 40% of these food sensitizations were symptomatic, including food‐dependent exercise‐induced anaphylaxis in six patients. Conclusions: Mustard allergy is a not‐uncommon disorder that can induce severe reactions. Significant associations with mugwort pollinosis and several plant‐derived food allergies are demonstrated, suggesting a new mustard–mugwort allergy syndrome. A relationship between this syndrome and food‐dependent exercise‐induced anaphylaxis is also reported.